Acute aortic dissection is a medical emergency requiring prompt diagnosis and management. To our knowledge, there have been no reports associating acute dissection of the aorta with methamphetamine abuse in Korea. The pharmacologic action of methamphetamine is similiar to that of cocaine : both promote release of norepinephrine and prevent norepinephrine uptake. Methamphetamine causes sudden, sharp increase in both the pulse wave and the blood pressure by causing both tachycardia and hypertension. Some studies have reported vasculitic lesions associated with methamphetamine abuse. We experienced a case of a 37 year old man with history of intravenous methamphetamine abuse who developed a dissection of the entire aorta and infarction of the right kidney, diagnosed by transthoracic echocardiography and computed tomography. He didn't have history of hypertension, the evidence of Marfan's syndrome, or other connective tissue disease. The two dimensional echocardiography demonstrated a intimal flap in the aorta.